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Kendler KS, Ohlsson H, Sundquist J, Sundquist K. Family Genetic Risk Scores and the Genetic Architecture of Major Affective and Psychotic Disorders in a Swedish National Sample. JAMA Psychiatry 2021; 78:735-743. [PMID: 33881469 PMCID: PMC8060884 DOI: 10.1001/jamapsychiatry.2021.0336] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/11/2021] [Indexed: 11/14/2022]
Abstract
Importance Family and genetic approaches have traditionally been used to evaluate our diagnostic concepts. Using a novel method, the family genetic risk score (FGRS), can we validate the genetic architecture of major affective and psychotic disorders in a national Swedish sample? Objective To determine whether FGRSs, calculated for the entire Swedish population, can elucidate the genetic relationship between major affective and psychotic disorders and clarify the association of genetic risk with important clinical features of disease. Design, Setting, and Participants This cohort study included the native Swedish population born from January 1, 1950, through December 31, 1995, and followed up through December 31, 2017. Data were collected from Swedish population-based primary care, specialist, and hospital registers, including age at first registration for a psychiatric diagnosis and number of registrations for major depression, bipolar disorder, and schizophrenia. Data were analyzed from October 15, 2020, to February 2, 2021. Exposures FGRSs for major depression, bipolar disorder, and schizophrenia calculated from morbidity risks for disorders in first- through fifth-degree relatives, controlling for cohabitation. Main Outcomes and Measures Diagnoses of major depression, bipolar disorder, schizophrenia, schizoaffective disorder, and other nonaffective psychoses (ONAPs), age at registration, and number of registrations for major depression, bipolar disorder, and schizophrenia. Diagnostic conversion of major depression to bipolar disorder and ONAPs to schizophrenia was assessed by Cox proportional hazards regression models. Results The cohort included 4 129 002 individuals (51.4% male) with a mean (SD) age at follow-up of 45.5 (13.4) years. Mean FGRSs for major depression, bipolar disorder, and schizophrenia produced distinct patterns for major depression, bipolar disorder, schizophrenia, schizoaffective disorder, and ONAPs with large separations between disorders. In major depression, bipolar disorder, and schizophrenia, high FGRSs were associated with early age at onset and high rates of recurrence: a high mean FGRS for bipolar disorder was associated with early age at onset (younger than 25 years, 0.11; 95% CI, 0.11-0.12) and higher recurrence (8 or more registrations, 0.11; 95% CI, 0.11-0.12) in major depression. The schizophrenia FGRS was separately associated with psychotic and nonpsychotic forms of major depression (0.10; 95% CI, 0.06-0.14 vs 0.03; 95% CI, 0.02-0.03) and bipolar disorder (0.22; 95% CI, 0.16-0.28 vs 0.11; 95% CI, 0.09-0.12). The bipolar disorder and schizophrenia FGRSs were associated with conversion from major depression to bipolar disorder (eg, hazard ratio, 1.70 [95% CI, 1.63-1.78] for high vs low bipolar FGRS) and ONAP to schizophrenia (eg, hazard ratio, 1.38 [95% CI, 1.27-1.51] for high vs low schizophrenia FGRS). Conclusions and Relevance In this Swedish cohort study, the FGRSs for major depression, bipolar disorder, and schizophrenia for the Swedish population clearly separated major affective and psychotic disorders from each other in a larger and more representative patient sample than previously possible. These findings provide possible validation, from a genetic perspective, for these major diagnostic categories. These results replicated and extended prior observations on more limited samples of the association of FGRS with age at onset, recurrence, psychotic subtypes, and diagnostic conversions.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond
- Department of Psychiatry, Virginia Commonwealth University, Richmond
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
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Alfimova MV, Lezheiko TV, Smirnova SV, Gabaeva MV, Golimbet VV. Effect of the C-reactive protein gene on risk and clinical characteristics of schizophrenia in winter-born individuals. Eur Neuropsychopharmacol 2020; 35:81-88. [PMID: 32402651 DOI: 10.1016/j.euroneuro.2020.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 03/16/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
C-reactive protein (CRP) levels are elevated in a subset of schizophrenia patients and correlated with more severe symptoms, which makes CRP a potential theranostic biomarker for the disease. However, genotypes associated with higher CRP concentrations have the protective effect against schizophrenia. To resolve this discrepancy, more research on the role of CRP in schizophrenia is needed. The present study aimed to investigate the effects on schizophrenia of the CRP gene in combination with season of birth (SOB), the known risk factor for the disease. We first examined the impact of seasonality on schizophrenia risk in the Russian population, using samples of 2452 patients and 1203 controls, and then assessed the CRP rs2794521 polymorphism × SOB interaction effect on the disease risk, age-of-onset and symptoms severity in 826 patients and 476 controls. An excess of winter births in patients was not significant. At the same time, we found that winter-born patients carrying the CRP GG genotype, which is associated with low transcriptional activity, had an earlier age at onset than the other patients. The findings are in line with the protective role of high active CRP genetic variants in the development of schizophrenia and provide support for the hypothesis that this effect of CRP takes place early in life.
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Affiliation(s)
- Margarita V Alfimova
- Department of Clinical Genetics, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russian Federation.
| | - Tatyana V Lezheiko
- Department of Clinical Genetics, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russian Federation
| | - Svetlana V Smirnova
- Department of Clinical Genetics, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russian Federation
| | - Marina V Gabaeva
- Department of Clinical Genetics, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russian Federation
| | - Vera V Golimbet
- Department of Clinical Genetics, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russian Federation
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Hatzimanolis A, Stefanatou P, Kattoulas E, Ralli I, Dimitrakopoulos S, Foteli S, Kosteletos I, Mantonakis L, Selakovic M, Soldatos RF, Vlachos I, Xenaki LA, Smyrnis N, Stefanis NC. Familial and socioeconomic contributions to premorbid functioning in psychosis: Impact on age at onset and treatment response. Eur Psychiatry 2020; 63:e44. [PMID: 32345391 PMCID: PMC7355181 DOI: 10.1192/j.eurpsy.2020.41] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background. Premorbid adjustment (PA) abnormalities in psychotic disorders are associated with an earlier age at onset (AAO) and unfavorable clinical outcomes, including treatment resistance. Prior family studies suggest that familial liability, likely reflecting increased genetic risk, and socioeconomic status (SES) contribute to premorbid maladjustment. However, their joint effect possibly indicating gene–environment interaction has not been evaluated. Methods. We examined whether family history of psychosis (FHP) and parental SES may predict PA and AAO in unrelated cases with first-episode psychosis (n = 108) and schizophrenia (n = 104). Premorbid academic and social functioning domains during childhood and early adolescence were retrospectively assessed. Regression analyses were performed to investigate main effects of FHP and parental SES, as well as their interaction. The relationships between PA, AAO, and response to antipsychotic medication were also explored. Results. Positive FHP associated with academic PA difficulties and importantly interacted with parental SES to moderate social PA during childhood (interaction p = 0.024). Positive FHP and parental SES did not predict differences in AAO. Nevertheless, an earlier AAO was observed among cases with worse social PA in childhood (β = −0.20; p = 0.005) and early adolescence (β = −0.19; p = 0.007). Further, confirming evidence emerged for an association between deficient childhood social PA and poor treatment response (p = 0.04). Conclusions. Familial risk for psychosis may interact with parental socioeconomic position influencing social PA in childhood. In addition, this study supports the link between social PA deviations, early psychosis onset, and treatment resistance, which highlights premorbid social functioning as a promising clinical indicator.
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Affiliation(s)
- Alex Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, 11521 Athens, Greece
| | - Pentagiotissa Stefanatou
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Emmanouil Kattoulas
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Irene Ralli
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Stefanos Dimitrakopoulos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Stefania Foteli
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Ioannis Kosteletos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Leonidas Mantonakis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Mirjana Selakovic
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Rigas-Filippos Soldatos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Ilias Vlachos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Lida-Alkisti Xenaki
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Nikolaos Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece.,University Mental Health, Neurosciences and Precision Medicine Research Institute, 11527 Athens, Greece
| | - Nicholas C Stefanis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, 11521 Athens, Greece.,University Mental Health, Neurosciences and Precision Medicine Research Institute, 11527 Athens, Greece
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Pepper EJ, Pathmanathan S, McIlrae S, Rehman FU, Cardno AG. Associations between risk factors for schizophrenia and concordance in four monozygotic twin samples. Am J Med Genet B Neuropsychiatr Genet 2018; 177:503-510. [PMID: 30134083 DOI: 10.1002/ajmg.b.32640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 11/08/2022]
Abstract
Concordance for schizophrenia is high in monozygotic twins but the extent to which concordance varies according to the presence of other schizophrenia risk factors is not well established. We aimed to investigate this in systematically ascertained twin samples. DSM-III-R/DSM-IV diagnoses were made from original data or published case histories from four systematically ascertained monozygotic twin samples. Probandwise concordance for schizophrenia was calculated according to the presence of psychotic disorder in first-degree relatives, birth order, gender, and age-at-onset. Logistic regression analysis was also performed to adjust for potential confounders. Psychotic disorder in parents and earlier age-at-onset were significantly associated with higher probandwise concordance for schizophrenia, including after adjustment for potential confounders. For example, when no parents had a psychotic disorder concordance was 34/88 (38.6%) versus 10/16 (62.5%) when one parent was affected; and for age-at-onset <23 years concordance was 25/46 (54.3%), declining to 13/44 (29.5%) for age-at-onset >30 years. These results are consistent with psychotic disorder in parents and age-at-onset being markers of the level of familial liability to schizophrenia and these factors may be useful in genetic counseling of monozygotic twins and in identifying and managing those at particularly high risk, if these findings are further replicated.
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Affiliation(s)
- Edward J Pepper
- Division of Psychiatry and Behavioural Sciences, Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Sasi Pathmanathan
- Division of Psychiatry and Behavioural Sciences, Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Shona McIlrae
- Division of Psychiatry and Behavioural Sciences, Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Faiz-Ur Rehman
- Lancashire Care NHS Foundation Trust, Preston, United Kingdom
| | - Alastair G Cardno
- Division of Psychiatry and Behavioural Sciences, Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
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Byrne M, Agerbo E, Mortensen PB. Family history of psychiatric disorders and age at first contact in schizophrenia: An epidemiological study. Br J Psychiatry 2018; 43:s19-25. [PMID: 12271795 DOI: 10.1192/bjp.181.43.s19] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BackgroundThe risk for schizophrenia has been associated with a family history of this and other psychiatric disorders. The relationship between age at first contact and family history of psychiatric illness is not certain.AimsTo estimate the risks for schizophrenia associated with a range of psychiatric diagnoses in family members and to investigate the relationship between these risks and age at first contact for schizophrenia.MethodA nested case–control study design was employed. Psychiatric admission data and socio-economic data were available for 7704 cases admitted between 1981 and 1998 in Denmark, 192 590 gender- and age-matched controls, and for the parents and siblings of all subjects.ResultsControlling for socio-economic factors, risk for schizophrenia was associated with a family history of all psychiatric disorders except substance misuse and independently with a family history of suicide. The risk for schizophrenia associated with a family history of psychiatric disorders decreased as age at first contact increased.ConclusionsRisk for schizophrenia is associated with a range of psychiatric disorders in family members and these risks are not constant across the risk period.
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Affiliation(s)
- Majella Byrne
- National Centre for Register-Based Research, Aarhus University, Taasingegade 1, Aarhus 8000 C, Denmark.
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Moreno-Izco L, Sánchez-Torres AM, Lorente-Omeñaca R, Fañanás L, Rosa A, Salvatore P, Peralta V, Cuesta MJ. Ten-year stability of self-reported schizotypal personality features in patients with psychosis and their healthy siblings. Psychiatry Res 2015; 227:283-9. [PMID: 25882099 DOI: 10.1016/j.psychres.2015.02.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 02/05/2015] [Accepted: 02/22/2015] [Indexed: 11/16/2022]
Abstract
Schizotypal personality disorder (SPD) symptoms or features are common in patients with psychosis and their healthy relatives. However, the long-term stability of these SPD features and therefore their constituting enduring traits underlying vulnerability to psychosis remain to be clarified. Thirty-two patients with psychotic disorders and 29 of their healthy siblings were included from the long-term follow-up study of 89 nuclear families. Participants were clinically assessed by means of a semi-structured diagnostic interview, whereas the Schizotypal Personality Questionnaire-Brief (SPQ-B) was applied for the self-assessment of SPD symptoms. The assessments were carried out upon admission to the study and at follow-up, about 10 years later. The patients had higher scores than their siblings on the SPQ-B both at baseline and follow-up. In addition, self-reported SPD symptoms remained stable over time in total scores and in all the SPQ-B subscores, except for the SPQ-B Disorganization subscale. Self-reported SPD symptoms were stable over the long term among patients with psychotic disorders and their healthy siblings. This finding provides new support for including the SPD construct as a trait measure for studies addressing both vulnerability to psychosis in first-degree relatives of patients with psychosis and long-term persistence of symptoms in patients suffering from psychosis.
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Affiliation(s)
- Lucía Moreno-Izco
- Psychiatric Unit B, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | | | - Lourdes Fañanás
- Unitat d'Antropologia, Departament Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Araceli Rosa
- Unitat d'Antropologia, Departament Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Paola Salvatore
- International Consortium for Bipolar and Psychotic Disorders Research, Department of Psychiatry, McLean Hospital-Harvard Medical School, Belmont, MA, United States; Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy
| | - Victor Peralta
- Psychiatric Unit B, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Manuel J Cuesta
- Psychiatric Unit B, Complejo Hospitalario de Navarra, Pamplona, Spain.
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Cuesta MJ, Basterra V, Sanchez-Torres A, Peralta V. Controversies surrounding the diagnosis of schizophrenia and other psychoses. Expert Rev Neurother 2014; 9:1475-86. [DOI: 10.1586/ern.09.102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gershon ES, Badner JA. Incorporation of molecular data and redefinition of phenotype: new approaches to genetic epidemiology of bipolar manic depressive illness and schizophrenia. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22034205 PMCID: PMC3181639 DOI: 10.31887/dcns.2001.3.1/esgershon] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Considerable advances have been made in identifying specific genetic components of bipolar manic depressive illness (BP) and schizophrenia (SZ), despite their complex inheritance. Meta-analysis of all published whole-genome linkage scans reveals overall support for illness genes in several chromosomal regions. In two of these regions, on the lonq arm of chromosome 13 and on the long arm of chromosome 22, the combined studies of BP and SZ are consistent with a common susceptibility locus for the two disorders. This lends some plausibility to the hypothesis of some shared genetic predispositions for BP and SZ. Other linkages are supported by multiple studies of specific chromosomal regions, most notably two regions on chromosome 6 in SZ. The velocardiofacial syndrome is associated with deletions very close to the linkage region on chromosome 22, and with psychiatric manifestations of both BP and SZ. Endophenotypes of SZ, previously demonstrated to be heritable, have been found to have chromosomal linkage in at least one study. These include eye-tracking abnormalities linked to the short arm of chromosome 6, and abnormality of the P50 cortical evoked potential linked to chromosome 15. Variants in specific genes have been associated with susceptibility to illness, and other genes have been associated with susceptibility to side effects of pharmacological treatment. These genetic findings may eventually be part of an integrated genetic, environmental, and interactive-factor epidemiology of the major mental illnesses.
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Affiliation(s)
- E S Gershon
- Department of Psychiatry, University of Chicago, Chicago, III, USA
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Svensson AC, Lichtenstein P, Sandin S, Öberg S, Sullivan PF, Hultman CM. Familial aggregation of schizophrenia: the moderating effect of age at onset, parental immigration, paternal age and season of birth. Scand J Public Health 2011; 40:43-50. [PMID: 21930618 DOI: 10.1177/1403494811420485] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS An abundance of evidence has firmly established the familial aggregation of schizophrenia. The aim of this study was to examine how age at onset, parental characteristics and season of birth modify the familiality in schizophrenia. METHODS A population-based cohort was created by linking the Swedish Multi-Generation and Hospital Discharge Registers. Among 5,075,998 full siblings born between 1932 through to 1990, 16,346 cases of schizophrenia were identified. Familial aggregation was measured by the sibling recurrence-risk ratio, defined as the risk of schizophrenia among full siblings of schizophrenia patients compared with the risk among siblings of unaffected people. RESULTS We found a statistically significantly lower recurrence-risk ratio in siblings of later onset cases (7.2; 95% confidence interval (95% CI) 6.7-7.9) than of early onset cases (10.8; 95% CI 9.4-12.2). A lower recurrence-risk ratio was observed among offspring to fathers above 40 years (6.3; 95% CI 5.3-7.3) as compared with offspring of younger fathers (8.6; 95% CI 8.0-9.3). Further, among offspring to parents born outside Sweden the recurrence-risk ratio was statistically significantly lower (maternal immigrants 4.8; 95% CI 4.0-5.7, paternal immigrants 5.7; 95% CI 4.6-6.9) than among offspring to parents born in Sweden. CONCLUSIONS The familial aggregation of schizophrenia was reduced by higher age at onset, advancing paternal age and immigrant status of parents.
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Affiliation(s)
- Anna C Svensson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Chien YL, Liu CM, Fann CSJ, Liu YL, Hwu HG. Association of the 3' region of COMT with schizophrenia in Taiwan. J Formos Med Assoc 2009; 108:301-9. [PMID: 19369177 DOI: 10.1016/s0929-6646(09)60070-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/PURPOSE The Val108/158Met (rs4680) single nucleotide polymorphism (SNP) in the catechol-O-methyltransferase (COMT) gene contributes to genetic susceptibility to schizophrenia, which is specifically related to impairments in executive functioning. A different genomic region composed of three SNPs (rs737865, rs4680, rs165599) within the COMT gene has been reported to be significantly associated with schizophrenia in Ashkenazi Jews. This study aims to clarify the association between these three SNPs and their haplotypes with schizophrenia and neurocognitive functioning, using both case-control and family-based designs. METHODS The case-control study included 124 schizophrenia patients and 112 healthy controls, while the family samples included 83 families with at least two affected siblings. The neurocognitive functioning was assessed by the Continuous Performance Test (CPT) and Wisconsin Card Sorting Test. The association analysis was performed using TRANSMIT and FBAT. RESULTS There was no significant association between the three SNPs and schizophrenia in the case-control study. In the family study, the A allele of rs165599 was transmitted preferentially to the affected individuals (p = 0.023), and significantly associated with a later age of onset (p = 0.018), more severe delusion/hallucination symptom dimension (p = 0.027), and poorer performance in the CPT (p = 0.04). The triple SNP haplotypes did not reveal any significant association with schizophrenia or neurocognitive function. CONCLUSION The SNP rs165599, which has been mapped to the 3'-UTR region of the COMT gene, was significantly associated with schizophrenia in our family study, and possibly associated with the age of onset, delusion/hallucination symptom dimension, and CPT performance. Therefore, COMT may contribute to the genetic risk for schizophrenia not through the Val108/158Met polymorphism, but through other variants that are situated 3' to this region, in the Taiwanese population. Nevertheless, the true associated functional variants in our subjects remain to be elucidated.
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Affiliation(s)
- Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Yun Lin Branch, Yunlin, Taiwan
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Difference in age of onset of psychosis between epilepsy and schizophrenia. Epilepsy Res 2008; 78:201-6. [DOI: 10.1016/j.eplepsyres.2007.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 09/25/2007] [Accepted: 12/07/2007] [Indexed: 11/18/2022]
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Abstract
There have been inconsistent findings regarding the significance of family history of schizophrenia spectrum disorders in relation to presentation and course of illness. There has been little research relevant to this issue from first-episode patients. We examined the differences in premorbid adjustment, symptoms, and intellectual functioning between 28 first-episode schizophrenia spectrum patients with a history of such illness in first degree relatives and 28 matched patients without such a family history. The results indicate that whereas the 2 groups did not differ in presenting symptoms, those with a positive family history showed poorer intellectual functioning and less reduction in symptoms at 2 and 3 year follow-up and greater likelihood of abnormal electroencephalogram findings. The findings provide evidence that presence of a positive family history in first-episode patients is associated with a more pernicious form of illness.
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Austin JC, Peay HL. Applications and limitations of empiric data in provision of recurrence risks for schizophrenia: a practical review for healthcare professionals providing clinical psychiatric genetics consultations. Clin Genet 2006; 70:177-87. [PMID: 16922717 DOI: 10.1111/j.1399-0004.2006.00658.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Schizophrenia is a common disorder that may frequently be encountered when taking family histories in the genetics clinic, whether or not the referral is for a psychiatric indication. Like in other common disorders, the provision of recurrence risks for schizophrenia is a complex clinical issue because empiric recurrence risks (while reasonably well established) can rarely be used without individual tailoring. This review seeks to identify and detail some pertinent issues surrounding the clinical utility of empiric recurrence risks for schizophrenia, and to provide an overview of important factors to consider when tailoring empiric risks for individual patients.
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Affiliation(s)
- J C Austin
- Centre for Complex Disorders and Department of Psychiatry, University of British Columbia, Vancouver General Hospital Research Pavillion, Vancouver, BC, Canada.
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Mathos KK, Gur RE, Lokar F, Calkins ME, Nimgaonkar V. A description of the process of recruitment for research studies investigating the genetics of psychotic illness. Curr Psychiatry Rep 2006; 8:307-12. [PMID: 16879795 DOI: 10.1007/s11920-006-0067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Collecting biometric data on probands and family members is pivotal for advancing the understanding and treatment of any medical disorder with genetic contributions. The process of recruiting probands with psychosis and their family members for genetic studies has proven to be challenging. We present the recruitment strategies of two sites that are collaborating in genetic studies. We review details of referral sources at these sites. Of 69 participants recruited from the University of Pittsburgh, 23% were self-referrals, 30% were encouraged by family, and 47% were encouraged by clinicians. Of 48 probands from the University of Pennsylvania, 6% were self-referrals, 21% were encouraged by family, and 73% were encouraged by clinicians. Qualitative data from focus groups are reviewed. Strategies that helped to facilitate recruitment and foster community networking are discussed. This preliminary study has broad implications as a potential model for collaboration among patient support groups, family groups, clinicians, and researchers.
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Affiliation(s)
- Kimberly K Mathos
- Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Husted JA, Greenwood CMT, Bassett AS. Heritability of schizophrenia and major affective disorder as a function of age, in the presence of strong cohort effects. Eur Arch Psychiatry Clin Neurosci 2006; 256:222-9. [PMID: 16331352 PMCID: PMC3130033 DOI: 10.1007/s00406-005-0629-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2005] [Accepted: 09/28/2005] [Indexed: 10/25/2022]
Abstract
It remains unclear whether age at onset for major psychiatric disorders is a useful marker of etiologic and genetic heterogeneity. The authors examined how heritability of schizophrenia and major affective disorders varied with age at onset. The sample was drawn from a large archival data set collected by Lionel Penrose, comprising 3,109 families with two or more members first hospitalized in Ontario between 1874 and 1944. The authors studied 1,295 sibships with schizophrenia (n = 487), major affective disorder (n = 378), both (n = 234) or neither (n = 196) of these disorders. Proportional hazards models were used to estimate how the hazard of hospitalization for each disorder (schizophrenia or major affective disorder) varied with proband age at onset, adjusted for changes in age at onset distribution between 1874 and 1944. A sibling's risk of hospitalization for the same illness significantly increased for each 10-year decrease in age at onset of the proband both for schizophrenia (hazard ratio = 1.21, 95 % confidence interval: 1.06, 1.39), and for affective disorder (hazard ratio = 1.29,95 % CI: 1.14, 1.45). Gender of proband was unrelated to sibling risk of the same illness, and tests of interaction effects between proband age at onset and gender on sibling risk were nonsignificant.
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Affiliation(s)
- Janice A Husted
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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Chen EYH, Dunn ELW, Miao MYK, Yeung WS, Wong CK, Chan WF, Chen RYL, Chung KF, Tang WN. The impact of family experience on the duration of untreated psychosis (DUP) in Hong Kong. Soc Psychiatry Psychiatr Epidemiol 2005; 40:350-6. [PMID: 15902405 DOI: 10.1007/s00127-005-0908-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous family experience of psychotic illness may play an important role in whether and when a patient seeks help in first-episode psychosis. This study investigated the relationship between family experience of psychosis and the duration of untreated psychosis in a prospective sample of first-episode psychosis patients in Hong Kong. We also studied the effects of pre-morbid adjustment, educational level, living alone, and mode of onset as potential determinants of the duration of untreated psychosis (DUP). METHODS A total of 131 first-episode psychosis patients in Hong Kong were recruited in a study of the DUP and related factors. The Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS) was used to measure the DUP and to provide a structured assessment of family history, educational level, household arrangement, and mode of onset. RESULTS Previous family experience of psychiatric illness (the presence of another family member who has been receiving psychiatric treatment) and an acute mode of onset were significant predictors of a shorter DUP. Educational level had a modest effect on its own, but was not significant in the binary logistic regression model. Living alone had a moderate effect size, but was non-significant, possibly because of the small proportion of single-person households in the sample. The symptom profile, pre-morbid adjustment, and other demographic factors were not significantly related to the DUP. CONCLUSION In addition to the mode of onset, previous family experience plays an important role in the presentation of early psychosis. Educational efforts that target the family should be an important part of any strategy for the early detection of psychosis.
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Affiliation(s)
- Eric Yu-Hai Chen
- Dept. of Psychiatry, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong.
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Cardno AG, Holmans PA, Rees MI, Jones LA, McCarthy GM, Hamshere ML, Williams NM, Norton N, Williams HJ, Fenton I, Murphy KC, Sanders RD, Gray MY, O'Donovan MC, McGuffin P, Owen MJ. A genomewide linkage study of age at onset in schizophrenia. AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 105:439-45. [PMID: 11449396 DOI: 10.1002/ajmg.1404] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is strong evidence for a genetic contribution to age at onset of schizophrenia, which probably involves both susceptibility loci for schizophrenia and modifying loci acting independent of disease risk. We sought evidence of linkage to loci that influence age at onset of schizophrenia in a sample of 94 affected sibling pairs with DSM-IV schizophrenia or schizoaffective disorder, and age at first psychiatric contact of 45 years or less. Individuals were genotyped for 229 microsatellite markers spaced at approximately 20 cM intervals throughout the genome. Loci contributing to age at onset were sought by a quantitative maximum-likelihood multipoint linkage analysis using MAPMAKER/SIBS. A nonparametric multipoint analysis was also performed. The genomewide significance of linkage results was assessed by simulation studies. There were six maximum-likelihood LOD score peaks of 1.5 or greater, the highest being on chromosome 17q (LOD = 2.54; genomewide P = 0.27). This fulfils Lander and Kruglyak's [1995: Nat Genet 11:241-247] criteria for suggestive linkage in that it would be expected to occur once or less (0.3 times) per genome scan. However, this finding should be treated with caution because the LOD score appeared to be almost solely accounted for by the pattern of ibd sharing at one marker (D17S787), with virtually no evidence of linkage over flanking markers. None of the linkage results achieved genomewide statistical significance, but the LOD score peak on chromosome 13q (LOD = 1.68) coincided with the region showing maximum evidence for linkage in the study by Blouin et al. [1998: Nat Genet 20:70-73] of categorical schizophrenia.
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MESH Headings
- Age of Onset
- Chromosome Mapping
- Chromosomes, Human, Pair 13/genetics
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 2/genetics
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 3/genetics
- Female
- Genetic Linkage
- Genome, Human
- Genotype
- Humans
- Lod Score
- Male
- Microsatellite Repeats
- Schizophrenia/genetics
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Affiliation(s)
- A G Cardno
- Department of Psychological Medicine, University of Wales College of Medicine, Cardiff, United Kingdom
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Abstract
Childhood-onset schizophrenia (defined by an onset of psychosis by age 12) is a rare and severe form of the disorder that is clinically and neurobiologically continuous with the adult-onset disorder. There is growing evidence for more salient risk or etiologic factors, particularly familial, in this possibly more homogeneous patient population. For the 49 patients with very early onset schizophrenia studied to date at the National Institute of Mental Health, there were more severe premorbid neuro-developmental abnormalities, a higher rate of cytogenetic anomalies, and a seemingly higher rate of familial schizophrenia and spectrum disorders than later onset cases. There was no evidence for increased obstetric complications or environmental stress. These data, while preliminary, suggest that a very early age of onset of schizophrenia may be secondary to greater familial vulnerability. Consequently, genetic studies of these patients may be particularly informative and may provide important etiologic information.
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Affiliation(s)
- R Nicolson
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland 20892-1600, USA
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Howard RJ, Graham C, Sham P, Dennehey J, Castle DJ, Levy R, Murray R. A controlled family study of late-onset non-affective psychosis (late paraphrenia). Br J Psychiatry 1997; 170:511-4. [PMID: 9330015 DOI: 10.1192/bjp.170.6.511] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The relationship between those schizophrenia-like conditions that have their onset in late life and early-onset schizophrenia is unclear. Very few family history studies of patients with late-onset psychosis have been reported, and it is not known whether their relatives have an increased risk of psychosis. METHOD Information was collected on the psychiatric morbidity of 269 first-degree relatives of patients with schizophrenia or delusional disorder with an onset after the age of 60 (late paraphrenia), and 272 first-degree relatives of healthy elderly control subjects, using a research diagnostic instrument. RESULTS With a narrow age range (15-50 years) at risk, the estimated lifetime risk of schizophrenia was 1.3% in the relatives of both cases and controls. With a wider age range (15-90 years) at risk, estimated lifetime risk of schizophrenia was 2.3% for the relatives of cases and 2.2% for the relatives of controls. However, depression was significantly more common among the relatives of cases than controls. CONCLUSIONS Those schizophrenia-like psychoses with onset in late life are not genetically associated with schizophrenia.
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